The gut microbiota as a target of probiotics and prebiotics to improve gestational diabetes mellitus: potential mechanisms

Gestational diabetes mellitus (GDM) affects both the short- and long-term health of mothers and their children, the possibility of using intestinal modulation to ameliorate GDM has become the focus of recent research. Ingesting probiotics and prebiotics during pregnancy can effectively reduce the incidence of GDM, therefore, clarifying the mechanisms by which gut regulation reduces GDM is vital. This article reviews the pathways and mechanisms by which the probiotics and prebiotics promote glucose homeostasis including regulating short-chain fatty acid and bile acid metabolism, increasing glutathione levels, modulating the endocannabinoid system, influencing the gut-brain axis, and improving tryptophan metabolism. Previous findings indicate that trimethylamine N-oxide and branched-chain amino acids are associated with GDM risk, while polyphenols, oligosaccharides, inulin, and other prebiotics can improve GDM outcomes. Additionally, this review identifies various limitations in existing mechanistic studies.